I friends mom is currently undergoing IV immunoglobulin therapy for her out of control Lupus. It is also used to treat intractable RA. Have you read on this...or looked into this therapy? I have not seem much on this subject posted here and was hoping for some feedback. A friend's son had it for Kawasaki's (I think it is the only treatment for that?). He was in the hospital a few days, but did fine with it and it worked for him. I hope your friend's mom has success, too.
hi lorster i have not heard of this for ra my son had kawasaki and as
susan said IV immunoglobulin is given..not sure if kawasaki can return..
IVIG is given as a plasma protein replacement therapy (IgG) for immune deficient patients which have decreased or abolished antibody production capabilities. In these immune deficient patients, IVIG is administered to maintain adequate antibodies levels to prevent infections and confers a passive immunity. Treatment is given every 3-4 weeks. In the case of patients with autoimmune disease, IVIg is administered at a high dose (generally 1-2 grams IVIG per kg body weight) to attempt to decrease the severity of the autoimmune disease.
The precise mechanism by which IVIG suppresses harmful inflammation has not been definitively established but is believed to involve the inhibitory Fc receptor.[1][2] The actual primary target(s) of IVIG in autoimmune disease are still unclear, however. IVIG may work via a multi-step model where the injected IVIG first forms a type of immune complex in the patient. [3] Once these immune complexes are formed, they interact with activating Fc receptors on dendritic cells[4]which then mediate anti-inflammatory effects helping to reduce the severity of the autoimmune disease or inflammatory state.
Additionally, the donor antibody may bind directly with the abnormal host antibody, stimulating its removal. Alternatively, the massive quantity of antibody may stimulate the host's complement system, leading to enhanced removal of all antibodies, including the harmful ones. IVIG also blocks the antibody receptors on immune cells (macrophages), leading to decreased damage by these cells, or regulation of macrophage phagocytosis.
IVIG may also regulate the immune response by reacting with a number of membrane receptors on T cells, B cells, and monocytes that are pertinent to autoreactivity and induction of tolerance to self.[5]
A recent report stated that IVIG application to activated T cells leads to their decreased ability to engage microglia. As a result of IVIG treatment of T cells, the findings showed reduced levels of tumor necrosis factor-alpha and interleukin-10 in T cell-microglia co-culture. The results add to the understanding of how IVIG may affect inflammation of the central nervous system in autoimmune inflammatory diseases.[6]
IVIG is useful in some acute infection cases such as in Kawasaki's Disease and pediatric HIV infection.
Abstract:
Intravenous immunoglobulin infusions should be used with caution in people with autoimmune disorders who also have risk factors for heart disease. The case reports of four patients who had a heart attack while receiving intravenous immunoglobulin are discussed.
Tumor necrosis factor (TNF) is a proinflammatory cytokine that is involved with normal inflammatory and immune responses and with the pathogenesis of chronic inflammatory medical conditions, such as rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, and Crohn's disease. The newest therapies for these inflammatory conditions include the TNF biologic response modifiers infliximab, etanercept, and adalimumab. Adalimumab is a human recombinant immunoglobulin G1 anti-TNF monoclonal antibody. As monotherapy, or in combination with methotrexate or other traditional disease-modifying antirheumatic drugs, adalimumab can produce improvements in the signs and symptoms associated with rheumatoid arthritis and can slow progression of the joint destruction. The adverse effect profile of adalimumab seems to be comparable to that of etanercept. Adalimumab also seems to be useful in the treatment of psoriasis, psoriatic arthritis, and Crohn's disease; however, none of these indications are approved by the US Food and Drug Administration, and the optimal dosing regimen for these indications has not been established.
PMID: 15580154 [PubMed - indexed for MEDLINE]